Process claims in the Australian Immunisation Register (AIR) 011-10100000

Recognised vaccination providers can send immunisation information to the AIR by completing:

• Australian Immunisation Register immunisation encounter form (IM018) to notify the AIR about vaccinations they have given
• Australian Immunisation Register immunisation history form (IM013) to notify the AIR when another provider administered the vaccination, including vaccines given overseas

Service Officers must promote reporting or updating immunisation information through the AIR site or Practice Management Software (PMS), where available.

The Australian Immunisation Register immunisation encounter (IM018) form identifies the following:

• individual's Medicare card and reference number (if available)
• individual's Healthcare Identifier number (IHI) if applicable
• individual’s name, address, gender, and date of birth
• if the individual is Aboriginal or Torres Strait Islander
• hepatitis B birth dose date (if applicable)
• the date/s immunisation/s were given
• vaccine details:
• brand name
• batch number
• vaccine type (funded by)
• route of administration
• any planned catch up option
• details of the vaccination provider

Note: from 1 March 2024, it is mandatory for vaccination providers to report:

• batch number, vaccine type and route of administration for Japanese Encephalitis Virus vaccines (JEV), and
• batch number and vaccine type for all National Immunisation Program (NIP), Influenza and COVID-19 vaccines administered in Australia

While these fields are mandatory to report for certain vaccines, if the information is provided on the form, it must be recorded on the AIR.

To record the vaccine type and/or route of administration on the AIR, Service Officers must send for delegation in PaNDA, after they have recorded the vaccine/s. The form will be delegated to a skilled group who will:

• add the vaccine type and/or route of administration, and
• finalise the PaNDA work item

The vaccine type and route of administration is optional to report when reporting vaccinations administered by another vaccination provider in Australia or given overseas. If this information is provided on the Australian Immunisation Register immunisation history form (IM013), it must be recorded.

The country of administration is only recorded for COVID-19 vaccines given overseas.

To record the country of administration, vaccine type and route of administration, Service Officers must escalate the form in PaNDA to a delegate after they have recorded the vaccine/s in AIR mainframe.

The skilled group assigned to the delegate role in PaNDA will:

• add the country of administration
• vaccine type, and
• route of administration

To process an Australian Immunisation Register immunisation history form (IM013) or Australian Immunisation Register immunisation encounter form (IM018), Service Officers must key a claim header in mainframe.

Information needed to key a claim header can include:

• immunising provider number
• information provider number
• claim ID
• receipt date of claim
• quoted number
• immunisation date

See the Process page for keying details.

The Header screen also identifies the:

• receipt method (for example, MAN for manual encounter forms (IM018), and FRM for the history forms (IM013)
• claim sequence number

Headers created from the IM018 or IM013 forms will contain one encounter.

Claim ID's consists of 1 alpha and 6 numerals (for example, X999999). When processing manual forms, (IM018 and IM013) Service Officers will need to create a claim ID using their P number.

Notification to the AIR of incorrectly recorded information may require an amendment to the header details recorded for a claim.

Note: amendments to headers can only occur if a payment for any of the encounters within the claim have not been made.

If the information keyed into a header is incorrect, an error message will display. See the Resources page for a list of header error messages.

Parents/guardians of individuals aged 14 years or under can provide their Aboriginal or Torres Strait Islander status when enrolling with Medicare.

Vaccination providers can notify the AIR of an individual's Aboriginal or Torres Strait Islander status. Supplying this information is voluntary and the vaccination provider must obtain consent before recording details on the AIR.

Indigenous status notifications

Vaccination providers may update the individual's Aboriginal or Torres Strait Islander status:

• through the AIR site, or
• by completing the applicable section of the Australian Immunisation Register immunisation encounter (IM018), or Australian Immunisation Register immunisation history (IM013) forms

In AIR Mainframe, the Aboriginal and Torres Strait Islander status indicator can be shown as 'Y', 'N' or blank when no information is recorded.

If an individual has their Aboriginal or Torres Strait Islander status recorded on Medicare CDMS located under the Personal section, this will display on the AIR record. A vaccination provider can only update the status through the AIR site where Medicare CDMS has no record.

Service Officers must:

• check Medicare CDMS first, when reviewing information received on an IM018 or IM013 form. If the information on Medicare CDMS is different, do not update
• complete the update on AIR Mainframe if there is no information on Medicare CDMS

Note: any update to the Aboriginal or Torres Strait Islander status recorded from the IM018 form or AIR site will show on AIR Mainframe only and not transmitted to Medicare for recording on Medicare CDMS.

A child up to 7 days of age usually receives the hepatitis B (Hep B) birth vaccine while in hospital.

When AIR receives Hep B birth dose information, process as a manual encounter or history depending on how the data was received.

This will ensure the Hep B birth dose will be:

• included in the AIR's assessment of a child's immunisation status
• reflected in the Completed Schedules field on the AIR Mainframe YIIS - Status and Due Overdue Details screen
• displayed on Immunisation Notifications Reconciliation Report, AIR site reports and immunisation history statements

The Hep B birth dose will not attract a provider information (notification) payment.

For more details on the process, see Table 2.

Children born on or after 1 October 2014:

• dose 4 of DTP due at 18 months of age
• dose 5 of DTP and dose 4 of polio due at 4 years of age

Children born before 1 October 2014:

• dose 4 of DTP and polio due at 4 years of age

Dose 4 given at 18 months of age must be recorded as dose 3.

When not all components of MMR have been given:

• leave the generic doses of MMR until a full valid dose has been completed
• if the record has single dose/s of:
• measles, mumps, or
• rubella, and
• full MMR, for example, Priorix, then R&Z the single doses and make the full dose appropriate dose number

The only valid reasons for not processing an immunisation encounter form include:

• where the data has already been entered, or
• the information provided is incomplete

If an immunisation encounter form is not processed, Service Officers must record a comment on PaNDA stating the reason for quality check purposes as per processing guidelines. See Work Optimiser for staff.

It is mandatory for providers to report batch numbers for:

• National Immunisation Program (NIP)
• COVID-19
• Influenza
• Japanese encephalitis (JEV)

Some vaccines have a lot number instead of a batch number. Enter the lot number when there is no batch number.

From 1 March 2024, it is mandatory for vaccination providers to report the route of administration for Japanese encephalitis vaccines (JEV).

Vaccination providers can choose 1 of the following options:

• Oral (PO)
• Subcutaneous (SC)
• Intradermal (ID)
• Intramuscular (IM)

Note: route of administration will be available to report for all other non-standard vaccines but only mandatory for JEV.

The route of administration is also required for the Jynneos brand of smallpox vaccine to determine the correct dose (injection volume) given. The route of administration required for Jynneos are:

• Injection volume of 0.5ml - Subcutaneous (SC), or
• Injection volume of 0.1ml - Intradermal (ID)

Service officers must escalate to a delegate:

• If the route of administration is missing from the:
• Australian Immunisation Register immunisation encounter form (IM018), or
• Australian Immunisation Register immunisation history form (IM013), and
• one of the above injection volumes is listed

The escalation will enable the skilled group to add the relevant route of administration in the AIR.

This field identifies how the vaccine was funded.

From 1 March 2024 it is mandatory for vaccination providers to report the vaccine type for all vaccines covered under the AIR rule 2015 including:

• National Immunisation Program (NIP), COVID-19, influenza (flu) vaccines, and
• Japanese encephalitis vaccines (JEV)

Optional reporting applies to all other non-standard vaccines.

Vaccination providers can choose 1 of the following options:

• NIP/Commonwealth (NIP) - Vaccines funded under the NIP or by the Commonwealth
• State Program (STP) - Vaccines funded under state or territory program
• Antenatal (AEN) - Vaccines administered to an individual who is pregnant
• Private (PRV) - Vaccines purchased privately - for example travel and flu vaccines not funded under the NIP

Note:

• the NIP/Commonwealth option - only used for NIP and COVID-19 vaccines
• the Antenatal option - selected when the individual is pregnant at the time the vaccine is administered. This is regardless of whether the vaccine is funded privately, under the NIP or a state and territory program.

Identify duplicate claims as follows:

• large batches of data submitted by the same vaccination provider
• all (or most) encounters in the claim are pended

This information will display on the record in a pended 'P' state. See Process pended claims in AIR.